Provider Demographics
NPI:1346552981
Name:LORENZ, MARGARET KATHLEEN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:LORENZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 CASPIAN WAY LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-5839
Mailing Address - Country:US
Mailing Address - Phone:336-201-5809
Mailing Address - Fax:
Practice Address - Street 1:1616 CASPIAN WAY LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-5839
Practice Address - Country:US
Practice Address - Phone:336-201-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7501224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant